Skip to main content
SpringerLink
Log in

Conversational metrics, psychopathological dimensions and self-disturbances in patients with schizophrenia

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Difficulties in interpersonal communication, including conversational skill impairments, are core features of schizophrenia. However, very few studies have performed conversation analyses in a clinical population of schizophrenia patients. Here we investigate the conversational patterns of dialogues in schizophrenia patients to assess possible associations with symptom dimensions, subjective self-disturbances and social functioning. Thirty-five schizophrenia patients were administered the Positive and Negative Syndrome Scale (PANSS), the Clinical Language Disorder Rating Scale (CLANG), the Scale for the Assessment of Thought, Language and Communication (TLC), the Examination of Anomalous Self-Experience Scale (EASE), and the Social and Occupational Functioning Assessment Scale (SOFAS). Moreover, participants underwent a recorded semi-structured interview, to extract conversational variables. Conversational data were associated with negative symptoms and social functioning, but not with positive or disorganization symptoms. A significant positive correlation was found between “pause duration” and the EASE item “Spatialization of thought”. The present study suggests an association between conversational patterns and negative symptom dimension of schizophrenia. Moreover, our findings evoke a relationship between the natural fluidity of conversation and of the natural unraveling of thoughts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The data that support the findings of this study are available on request from MT. The data are not publicly available due to ethical and privacy restrictions.

Code availability

Not applicable.

Abbreviations

ABaCO:

Assessment Battery of Communication Scale

BTP:

Between Turn Pauses

CLANG:

Clinical Language Disorder Rating Scale

EASE:

Examination of Anomalous Self-Experience Scale

PANSS:

Positive and Negative Syndrome Scale

SDs:

Self-Disturbances

SOFAS:

Social and Occupational Functioning Scale

TLC:

Thought, Language and Communication Scale

References

  1. Bleuler E (2014) Dementia praecox oder Gruppe der Schizophrenien. Neuausgabe, Psychosozialverlag

    Google Scholar 

  2. Couture SM, Penn DL, Roberts DL (2006) The functional significance of social cognition in schizophrenia: a review. Schizophr Bull 32(1):44–63. https://doi.org/10.1093/schbul/sbl029

    Article  Google Scholar 

  3. Crow TJ (2000) Schizophrenia as the price that Homo sapiens pays for language: a resolution of the central paradox in the origin of the species. Brain Res Brain Res Rev 31:118–129. https://doi.org/10.1016/s0165-0173(99)00029-6

    Article  CAS  PubMed  Google Scholar 

  4. Kraepelin E (1899) Psychiatrie Ein Lehrbuch für Studierende und Ärzte, 6th edn. Johann Ambrosius Barth

    Google Scholar 

  5. Drew P (2005) Conversation analysis. In: Fitch KL, Sanders RE (eds) Handbook of language and social interaction. Lawrence Erlbaum, pp 71–102

    Google Scholar 

  6. Schegloff EA (1992) Repair after next turn: the last structurally provided defence on intersubjectivity in conversation. Am J Sociol 97(5):1295–1345. https://doi.org/10.1086/229903

    Article  Google Scholar 

  7. Beebe B, Sorter D, Rustin J, Knoblauch S (2003) A comparison of Meltzoff Trevarthen and Stern. Psychoanal Dialogues 13(6):777–804. https://doi.org/10.1080/10481881309348768

    Article  Google Scholar 

  8. Trevarthen C (1994) The self born in intersubjectivity: the psychology of an infant communicating. In: Neisser U (ed) The perceived self: ecological and interpersonal sources of self knowledge. Cambridge University Press, pp 121–173

    Chapter  Google Scholar 

  9. Blankenburg W (1971) Der verlust der natürlichen selbstverständlichkeit. ein beitrag zur psychopathologie symptomarmer schizophrenien. Ferdinand Enkel Verlag

    Google Scholar 

  10. Kimura B (1992) Ecrits de psychopathologie phénomenologique. Presses Universitaires de France

    Google Scholar 

  11. Kimura B (1995) Zwischen Mensch und Mensch E. Weinmayr, Trans. Wissenschaftliche Buchgesellschaft

    Google Scholar 

  12. Minkowski E (1927) La schizophrénie: psychopathologie des schizoïdes et des schizophrènes. Payot

    Google Scholar 

  13. Stanghellini G, Ballerini M, Mancini M (2017) Other persons: on the phenomenology of interpersonal experience in schizophrenia (Ancillary Article to EAWE Domain 3). Psychopathology 50:75–82. https://doi.org/10.1159/000456037

    Article  PubMed  Google Scholar 

  14. Van Duppen Z (2016) Schizophrenia: a disorder of intersubjectivity. A phenomenological analysis. University of Heidelberg

    Google Scholar 

  15. Parnas J, Handest P (2003) Phenomenology of anomalous self-experience in early schizophrenia. Compr Psychiatry 44(2):121–134. https://doi.org/10.1053/comp.2003.50017

    Article  PubMed  Google Scholar 

  16. Sass LA, Parnas J (2003) Schizophrenia, consciousness and the self. Schizophr Bull 29(3):427–444. https://doi.org/10.1093/oxfordjournals.schbul.a007017

    Article  PubMed  Google Scholar 

  17. Pienkos E, Sass L (2017) Language: on the phenomenology of linguistic experience in schizophrenia (Ancillary Article to EAWE Domain 4). Psychopathology 50:83–89. https://doi.org/10.1159/000455195

    Article  PubMed  Google Scholar 

  18. Sass L, Pienkos E, Skodlar B, Stanghellini G, Fuchs T, Parnas J, Jones N (2017) EAWE: examination of anomalous world experience. Psychopathology 50:10–54. https://doi.org/10.1159/000454928

    Article  PubMed  Google Scholar 

  19. Colle L, Angeleri R, Vallana M, Sacco K, Bara BG, Bosco FM (2013) Understanding the communicative impairments in schizophrenia: a preliminary study. J Commun Disord 46:294–308. https://doi.org/10.1016/j.jcomdis.2013.01.003

    Article  PubMed  Google Scholar 

  20. Sacco K, Angeleri R, Bosco FM, Colle L, Davide M, Bara BG (2008) Assessment battery for communication-ABaCo: a new instrument for the evaluation of pragmatic abilities. Cogn Sci 9:111–157. https://doi.org/10.17791/jcs.2008.9.2.111

    Article  Google Scholar 

  21. Alpert M, Rosenberg SD, Pouget ER, Shaw RJ (2000) Prosody and lexical accuracy in flat affect schizophrenia. Psychiatry Res 97(2–3):107–118. https://doi.org/10.1016/s0165-1781(00)00231-6

    Article  CAS  PubMed  Google Scholar 

  22. Cannizzaro MS, Cohen H, Rappard F, Snyder PJ (2005) Bradyphrenia and bradykinesia both contribute to altered speech in schizophrenia: a quantitative acoustic study. Cog Behav Neurol 18(4):206–210. https://doi.org/10.1097/01.wnn.0000185278.21352.e5

    Article  Google Scholar 

  23. Compton MT, Lunden A, Cleary SD, Pauselli L, Alolayan Y, Halpern B, Broussard B, Crisafio A, Capulong L, Balducci PM, Bernardini F, Covington MA (2018) The aprosody of schizophrenia: computationally derived acoustic phonetic underpinnings of monotone speech. Schizophr Res 197:392–399. https://doi.org/10.1016/j.schres.2018.01.007

    Article  PubMed  PubMed Central  Google Scholar 

  24. Martínez-Sánchez F, Muela-Martínez JA, Cortés-Soto P, García Meilán JJ, Vera Ferrándiz JA, Egea Caparrós A, Pujante Valverde IM (2015) Can the acoustic analysis of expressive prosody discriminate schizophrenia? Span J Psychol 18(e86):1–9. https://doi.org/10.1017/sjp.2015.85

    Article  Google Scholar 

  25. Tahir Y, Yang Z, Chakraborty D, Thalmann N, Thalmann D, Maniam Y, Binte Abdul Rashid NA, Tan BL, Lee Chee Keong J, Dauwels J (2019) Non-verbal speech cues as objective measures for negative symptoms in patients with schizophrenia. PLoS ONE 14(4):e0214314. https://doi.org/10.1371/journal.pone.0214314

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Sichlinger L, Cibelli E, Goldrick M, Mittal VA (2019) Clinical correlates of aberrant conversational turn-taking in youth at clinical high-risk for psychosis. Schizophr Res 204:419–420. https://doi.org/10.1016/j.schres.2018.08.009

    Article  PubMed  Google Scholar 

  27. Sass L, Pienkos E (2013) Beyond words: linguistic experience in melancholia, mania and schizophrenia. Phenom Cogn Sci 14:475–495. https://doi.org/10.1007/s11097-013-9340-0

    Article  Google Scholar 

  28. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, DSM-5. American Psychiatric Association Publishing

    Book  Google Scholar 

  29. Andreasen NC, Carpenter WT Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR (2005) Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 162(3):441–449. https://doi.org/10.1176/appi.ajp.162.3.441

    Article  PubMed  Google Scholar 

  30. Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198. https://doi.org/10.1016/0022-3956(75)90026-6

    Article  CAS  PubMed  Google Scholar 

  31. First MB, Williams JBW, Karg RS, Spitzer RL (2016) Structured clinical interview for DSM-5 disorders, clinician version (SCID-5-CV). American Psychiatric Association Publishing

    Google Scholar 

  32. Kay SR, Flszbeln A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13(2):261–276. https://doi.org/10.1093/schbul/13.2.261

    Article  CAS  PubMed  Google Scholar 

  33. van der Gaag M, Hoffman T, Remijsen M, Hijman R, de Haan L, van Meijel B, van Harten PN, Valmaggia L, de Hert M, Cuijpers A, Wiersma D (2006) The five-factor model of the positive and negative syndrome scale ii: a ten-fold cross-validation of a revised model. Schizophr Res 85(1–3):280–287. https://doi.org/10.1016/j.schres.2006.03.021

    Article  PubMed  Google Scholar 

  34. Chen EYH, Lam LCW, Kan CS, Chan CKY, Kwok CL, Nguyen DGH, Chen RYL (1996) Language disorganisation in schizophrenia: validation and assessment with a new clinical rating instrument. Hong Kong J Psychiatry 6:4–13

    Google Scholar 

  35. Andreasen N (1986) Scale for the assessment of thought, language and communication. Schizophr Bull 12(3):473–482. https://doi.org/10.1093/schbul/12.3.473

    Article  CAS  PubMed  Google Scholar 

  36. Vita A, Dieci M, Giobbio GM, Caputo A, Ghiringhelli L, Comazzi M, Garbarini M, Mendini AP, Morganti C, Tenconi F, Cesana B, Invernizzi G (1995) Language and thought disorder in schizophrenia: brain morphological correlates. Schizophr Res 15(3):243–251. https://doi.org/10.1016/0920-9964(94)00050-i (PMID: 7632621)

    Article  CAS  PubMed  Google Scholar 

  37. Parnas J, Møller P, Kircher T, Thalbitzer J, Jansson L, Handest P, Zahavi D (2005) EASE: examination of anomalous self-experience. Psychopathology 38(5):236–258. https://doi.org/10.1159/000088441

    Article  PubMed  Google Scholar 

  38. Goldman HH, Skodol AE, Lave TR (1992) Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 149(9):1148–1156. https://doi.org/10.1176/ajp.149.9.1148

    Article  CAS  PubMed  Google Scholar 

  39. Ceccherini-Nelli A, Crow TJ (2003) Disintegration of the components of language as the path to a revision of Bleuler’s and Schneider’s concepts of schizophrenia: linguistic disturbances compared with first-rank symptoms in acute psychosis. Br J Psychiatry 182:233–240. https://doi.org/10.1192/bjp.182.3.233

    Article  PubMed  Google Scholar 

  40. Ceccherini-Nelli A, Turpin-Crowther K, Crow TJ (2007) Schneider’s first rank symptoms and continuous performance disturbance as indices of dysconnectivity of left- and right-hemispheric components of language in schizophrenia. Schizophr Res 90(1–3):203–213. https://doi.org/10.1016/j.schres.2006.09.017

    Article  PubMed  Google Scholar 

  41. Boersma P, Weenink D (2018) Praat: doing phonetics by computer [Computer program]. (Version 6.0.39).

  42. R Core Team (2019) R: A language and environment for statistical computing. R foundation for statistical computing. Vienna, Austria. https://www.R-project.org/.

  43. Wickham H (2017) Tidyverse: easily install and load the 'tidyverse'. R package version 1.2.1. https://CRAN.R-project.org/package=tidyverse

  44. Murphy BP, Chung YC, Park TW, McGorry PD (2006) Pharmacological treatment of primary negative symptoms in schizophrenia: a systematic review. Schizophr Res 88(1):5–25. https://doi.org/10.1016/j.schres.2006.07.002

    Article  PubMed  Google Scholar 

  45. Worswick E, Dimic S, Wildgrube C, Priebe S (2018) Negative symptoms and avoidance of social interaction: a study of non-verbal behaviour. Psychopathology 51(1):1–9. https://doi.org/10.1159/000484414

    Article  PubMed  Google Scholar 

  46. Loch AA (2019) Schizophrenia, not a psychotic disorder: bleuler revisited. Front Psychiatry 10:328. https://doi.org/10.3389/fpsyt.2019.00328

    Article  PubMed  PubMed Central  Google Scholar 

  47. Marchesi C, Affaticati A, Monici A, De Panfilis C, Ossola P, Ottoni R, Tonna M (2015) Decrease of functioning in remitted and non-remitted patients 16 years after a first-episode schizophrenia. J Nerv Ment Dis 203(6):406–411. https://doi.org/10.1097/NMD.0000000000000299

    Article  PubMed  Google Scholar 

  48. Tonna M, Ossola P, Marchesi C, Bettini E, Lasalvia A, Bonetto C, Lenzi J, Rucci P, Iozzino L, Cellini M, Comacchio C, Cristofalo D, D’Agostino A, de Girolamo G, De Santi K, Ghigi D, Leuci E, Miceli M, Meneghelli A, Pileggi F, Scarone S, Santonastaso P, Torresani S, Tosato S, Veronese A, Fioritti A, Ruggeri M; GET UP Group (2019) Dimensional structure of first episode psychosis. Early Interv Psychiatry 13(6):1431–1438. https://doi.org/10.1111/eip.12789

    Article  Google Scholar 

  49. Levinson SC, Torreira F (2015) Timing in turn-taking and its implications for processing models of language. Front Psychol 6:731. https://doi.org/10.3389/fpsyg.2015.00731

    Article  PubMed  PubMed Central  Google Scholar 

  50. Gozé T, Moskalewicz M, Schwartz MA, Naudin J, Micoulaud-Franchi JA, Cermolacce M (2018) Is “praecox feeling” a phenomenological fossil? A preliminary study on diagnostic decision making in schizophrenia. Schizophr Res 204:413–414. https://doi.org/10.1016/j.schres.2018.07.041

    Article  PubMed  Google Scholar 

  51. Rümke HC (1958) Der klinische differenzierung innerhalb der gruppe der schizophrenien. Nervenarzt 29:49–53

    PubMed  Google Scholar 

  52. Gozé T, Moskalewicz M, Schwartz MA, Naudin J, Micoulaud-Franchi JA, Cermolacce M (2019) Reassessing “Praecox Feeling” in diagnostic decision making in schizophrenia. Critical Rev Schizophr Bull 45(5):966–970. https://doi.org/10.1093/schbul/sby172

    Article  Google Scholar 

  53. Lucarini V, Grice M, Cangemi F, Zimmermann JT, Marchesi C, Vogeley K, Tonna M (2020) Speech prosody as a bridge between psychopathology and linguistics: the case of the schizophrenia spectrum. Front Psychiatry 11:531863. https://doi.org/10.3389/fpsyt.2020.531863

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The research for this paper has been funded by the German Research Foundation (DFG) as part of the SFB 1252 “Prominence in Language” in project A02 “Individual behavior in encoding and decoding prosodic prominence” at the University of Cologne. The funding source had no role in the design of this study, in its execution, analyses, interpretation of the data, or decision to submit results.

Author information

Authors and Affiliations

  1. Department of Mental Health, Azienda Unità Sanitaria Locale di Parma, Parma, Italy

    Valeria Lucarini, Benyamin Daniel Daniel, Francesca Paraboschi, Carlo Marchesi & Matteo Tonna

  2. IfL-Phonetics, University of Cologne, Cologne, Germany

    Francesco Cangemi & Martine Grice

  3. Psychiatry Unit, Department of Medicine and Surgery, Medical Faculty, University of Parma, Parma, Italy

    Jacopo Lucchese, Carlo Marchesi & Matteo Tonna

  4. Department of Statistical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy

    Chiara Cattani

  5. Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany

    Kai Vogeley

  6. Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany

    Kai Vogeley

Authors
  1. Valeria Lucarini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francesco Cangemi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Benyamin Daniel Daniel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jacopo Lucchese
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francesca Paraboschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chiara Cattani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carlo Marchesi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Martine Grice
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kai Vogeley
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Matteo Tonna
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

VL conceived and designed the study, selected the patients, collected the data, undertook the statistical analyses, managed the literature searches and wrote the manuscript. FC conceived and designed the study and analyzed the data. BDD administered the EASE scale to patients. JL and FP selected the patients and collected the data. CC undertook the statistical analyses. CM, MG, KV conceived and designed the study. MT conceived and designed the study, selected the patients, undertook the statistical analyses and wrote the manuscript. All authors contributed to and have approved the final manuscript.

Corresponding author

Correspondence to Valeria Lucarini.

Ethics declarations

Conflict of interest

Authors declared no potential conflict of interest with respect to the research, authorship and/or publication of this article.

Ethics approval

All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

All participants provided a written informed consent for the participation to the study.

Consent for publication

All participants received written information about the purpose of the study with the explanation that data will be analyzed in aggregate form and made available for publication and they provided written consent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lucarini, V., Cangemi, F., Daniel, B.D. et al. Conversational metrics, psychopathological dimensions and self-disturbances in patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 272, 997–1005 (2022). https://doi.org/10.1007/s00406-021-01329-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-021-01329-w

Keywords

Search

Navigation